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9902-026 (SFD)LICENSED CONTRACTOR DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of I_ *Chapter 9 (commencing with Section 7000) of Division 3 of the Business and W` Professionals Code, and my License is in full force and effect. O =),C,) License # Lic. Class Exp. Date .w cY�?3�9 z3 iiirf3l/iit Z F-_ Date Signature of Contractor C) p. ( .� J .0 OWNER -BUILDER DECLARATION W W. I hereby affirm under penalty of perjury that I am exempt from the Contractor's ~ a License Law for the following reason: •Z ( ,) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure isnot intended or offered for sale (Sec. 7044, Business & Professionals Code). ( ') I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). I am exempt under Section B&P.C. for this reason N Date Signature of Owner " O.'rn Q; Q WORKER'S COMPENSATION DECLARATION p.:2'. CcZ. I hereby affirm under penalty of perjury one of the following declarations: LO H O () 1 have and will maintain a certificate of consent to self -insure for workers' X W. LL compensation, as provided for by Section 3700 of the Labor Code, for the O J Q performance of.the work for which this permit is issued. m. < U. ( ) 1 have and will maintain workers' compensation insurance, as required by r O .0 Q Section 3700 of the Labor Code, for the performance of the work for which this Lo. Z permit is issued. My workers' compensation insurance carrier & policy no. are: It Carrier Policy No. �- � 0 46 99,rn00 r13 J (This section need not be completed if the permit valuation is for $100.00 or less). () I certify that in,the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject10 the workers: compensation provisions of Section 3700 of the Labor E3 ode, I/shall forthwith comply with those provisions. Date:1/ ;�.. 1 APPlicant Warning: Failure to -secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition`to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for. a permit subject to the conditions and restrictions set forth on his application. -- 1: Each person. upon whose behalf this application is made '& each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as 'a result of this applicaton agrees to, & shall, indemnify & hold harmless theCity of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days.will subject permit to cancellation. I certify that'I have read this application and state that the above information is correct agree to comply with all City; and State laws relating to the building coa truction, and hereby authorize representatives of this City to enter upon ttie above-mentioned property for inspection purposes. Signature (Owner/Agent) _ Date /' Y BUILDING PERMIT PERMIT# 9r183'2-eDxda DATE jJ412.Sl114��)i) VALUATION 4'17,2 ,747 J1) LOT 65 TRACT 25429 ADDRESS JOB SITE 7'9'^!•0 J A.ti...9 I51iL? N Z t R AJ E , APN 7iD .• 2 1�� . OWNER CONTRACTOR / DESIGNER / ENGINEER 4i ir'hrt�4' T A r:I' � r 0A JrT'V f, I.YIi tJ t.1 IL 1 tl,i/`i �r1 4 1r1 -J 'r~ncrr, I%Tr, lie 1l1 --kJ TI.iY lJ,V L., f4"479_3 ii i° 1 1@ i `3FE WS 74 785 F1 -I,ilr SIT ,W3 INDJAN WE.IS CA 92210 MAAid `1�t t.l.S CA. 92210 (766)776-4450 (AIA 3025 USE OF PERMIT t• - �?. Tivsti #Jiali u;s1' it"� I3.irC 3�.' e'AL i'�J.18.f:fG�e� CIS 20,00 qr J i m �,1�y R� �°•�, y�yp�) Y1 �p �q�,� Qy�}!'E..t rXEA'lS��L�'+.+'11�;'.Y9'�,9�'�'6.Y!'N�P;RdIM.B,IV•th d r� G4J�1lE f�f�i y�g�i, �' y�q;'1 g7x,� MARV Flit 17EPOSIT :101-fTti0439-318 425L0.00 R��L�'n5✓fifJ'YJi•i�1CAL FEA � V �"' tw,+1:J-<fL% •f �i1�i l.Eft) fii.EC IOC'AL 17 M, 101.000-420K000 5245.79 PLIA4BING FEE, 101-00-419-M $275.75 ORAVING F M 104-000423-000 t3.CJU 225-000-443.342 1.41:i .96 A1tT it31�t l4 l.`I,G Pl i!�t i�. S1� `lp:l (10(12 "(?Ui? $304.42 P'f,A—N 0"T".,C€:. F017 101-000-439-318 $928.68 S! lei-TCYLM, C0?N,;;17,RUr,110N AND ►'J,,AN CIMCK $7,918.2-R LESS PT'.E�MT.)1'T ES 4250 00 TOT AltJlIeliMIT FUS ,�k1?�+: �� lfi,f►fi�Y.?.Li RECEIPT DATE / BYDATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE I INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs - Underground Ducts Forms & Footings C7 Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing Compressor Insulation Vents Fireplace P.L. Grills Fireplace.T.O. Fans 8 Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS - SPAS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines G -Y Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test / Appliances Final Final Utility Notice (Gas) - �j •� ELECTRICAL APPROVALS Temp. Power Pole j— -7-7-JS "-- Underground Conduit Rough Wiring Law Voltage Wiring. Fixtures Main Service Sub Panels Exterior Receptacles G. F.I. Smoke Detectors Temp. Use of Power Final - Utility Notice (Perm) - C COMMENTS: Building Address Tay/ P.O. BOX 1504 ri 78-495 CALLE TAMPICO k' a rt ,Q 11_ LA QUINTA, CALIFORNIA 92253 /11"(WOOV7E(Il (. AJ" 17FU07JIV Mailing 1 (� Addres4i/'')1£ !'fGt1 t/ �� t ' )r , , F A i City f Zip Tel. ,JAM117I6 �(t �i1Llo Contractors ✓v/i�i/s7,("�IG/ City jZip State Lic.�,� City & Classif. I, l 3 � � � Lic. # 30 5 Arch., Engr., r^ r Designer v ►q�/f'l�� c% ;�6Nfd f1� Address Tel. CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 71X)0) of Division 3 of the Business and Professions Code, and my license is in full force and effect. r SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to -its Issuance also requires the applicant for such permit to filo a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. or that. he is exempt therefrom, and the basis for in ealleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I.: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) I'1 I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) 1'71 1 am exempt under Sec. B. 8 P.C. for. this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company r7 Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of the work. for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. ' Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. i CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. APPLICATION ONLY BUILDING: TYPE'CONST. OCC. GRP. A.P. Number A "15 to 0v� t' Legal Description L 0 T Gs Project Description �J i Sq. Ft. 3/d M g Sto Size No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ tstlmateo valuation PERMIT I AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front SetbacArom Center Line Rear Setback frrom Rear Prop. Line Side Street Setback from Center Line pp Side Setback from Property Line FINAL DATE f f INSPECTOR Issued by: Date Permit 'DEC Validated by: Signature of applicant Date Mailing Address Validyation:—'• — '. a41� I s City, State, Zip ,kt WHITE = FINANCE YELLOW = APPLICANT L� PINK = BUILDING DIVISION 't r. M t Notice: Document Cannot Be Duplicated Date 2/9/99 Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 760-771-8515 CERTIFICATE OF COMPLIANCE APN # 769-542-021 No. 18340 Jurisdiction La Quinta Owner NameMinistrelli-Painted Cove, Inc. No. 79-200 Street Jack Rabbit Trail City La Quinta zip 92253 Tract # Lot # `S Square Footage Type of Development " Single Family Residence ,t Comments Permit # Log # Study Area 1 1 No. of Units 1 At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: i Under Mitigation Agreement l EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Mitigation Agreement in the amount 5.f 628.00 X 1 or $ 628.00 the property listed above and that building a permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued ' Fees Paid By cc/First Community Bank/Kevin f ": `~ Telephone 776-4450 Name on the check By Dr. Doris Wilson Superintendent 1 Fee collected /exempted by Adriana Gauto Signature Payment Received $628.00 Check No. 084737 (NOTICE: Pursuant of Assembly Bill.0081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified I above will begin to run from the dare on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to collect them on the Dislrict('s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers. , Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting t OF PUBLIC WORKS CLEARANCE LETTER FOR CUSTOM HOME LOTS i Dear Builder: Prior to issuance of a building permit, you will be required to obtain clearance from the Public Works .Department for one, or more, of the following: 1: Verification that rough grading is complete, and the pad elevation certifications prepared by a licensed surveyor, or engineer, are on file in the Public Works Department. i. 2. Verification that infrastructure improvements and other required tract improvements are complete, or sufficiently advanced to warrant building permit issuance. 3. Prepare an engineered grading plan that provides for on -lot storm water retention, and have it checked and approved by the Public Works Department. t 3 • Tract 26524 (Estancias) s • Tract 26769 (Mountain View Estates) r I 4. Prepare an engineered grading plan that provides for building pad grading in accordance with the existing soils report and tract grading plan, and have it checked and approved by the Public Works Department. '• Tract 28034 (South Valley Estates) e FOR INTERNAL USE BY PUBLIC WORKS DEPARTMENT T_ TRACT: Z� LOT: �e 5 PUBLIC WORKS AUT ORIZATION DATE } FAPWDEPTIDOCSIFORMSIPW CLEARANCE LETTER.ss COMMENTS: "OCT -22-98 THU 03:i 14 PM MDS CONSULTING r r' MDS CONSULTIN PLANNERS . ENGINEERS • SURVEYORS 17320 Redhill Avenue, Suite 350 Irvine, CA $2614 i. October 22, 1998 Engineering Department City of La Quinta 78-495 Calle Tampico La Quinta, CA 92253 FAX NO. 714 251 0516 P. 01 L.q, i1r-cr� Post -it" Fax Note 7671 owe 101, 1. 70 Wo From COJPj• Co. Phone s Phone o Fax !r7 _ Fax x Rough Grading Verification La Quinta - Tract 25429 i • We have checked the area referenced below and find it to be in substantial conformance the approved rough grading plan. I Lot # Elev. As -Built Elev. Variation 54 45.0 45.1 0.1' 57 46.1 None C65);4[ 7 3,- C, 7:3� CN one 66 48.1 None 70- 50.5 50.4 0.1' Z2 49.5.E 49.5 None 73 47.3 47.3 None 74 47.0 47.0 None 75 46.6 46.7 0.1' 0 Manley i,. IVIQFW R.C.E. 20596 Expires 9130/01 G:x30T04\0erqi54.57.65-66.70.72-75. doe Q�pF ESS /QZ� 0� No. 20596 Fxp. 9-30-01 � 01 X _MDS STANLEY C.'MORSE GARY DOKICH SKIP SCHULTZ • i' J YOUNG ENGINEERING SERVICES 47-159 Youngs Lane, Indio, Ca. 92201 (760) 342.9214 fax (760) 342-6164 January 8, 1999 Tom Hartung Building Official City. of La Quinta Re: Truss Review for.Lot 6jr/Painted Cove, La Ouinta Dear Tom, We have reviewed the truss submittal package prepared by Spates Fabricators for the above project and found it to be in substantial conformance with the approved plans. If you have any questions or concerns please call. S' c relyJYo f � )FE$s J Bg S.E. No. 4,044 w m M: * Exp. 3 - 31- ?,v+l p �OF CALIFUF�